What is Molluscum Contagiosum?

" Molluscum contagiosum is a common skin infection caused by a poxvirus. It appears as raised, pearl-like skin bumps which are called nodules or papules that can appear on the skin, on the tongue or in the mouth. Most cases are on the genitals, body trunk, hands and face.The infection occurs worldwide but has a higher distribution in tropical countries where the climate is warm. It also has a higher incidence among sexually active adults, young children, and people who have weakened immune systems."  

Causes and is Molluscum Contagiosum Contagious?

The poxvirus Molluscum contagiosum may be acquired in a number of ways. The infection usually spreads by direct contact with a lesion, making it common among children and athletes. Sexually active adults also acquire the infection and early lesions on the genitals may be mistaken for warts or herpes, although these lesions are painless.

molluscumcontagiosum
Picture of Child with Molluscum Contagiosum on Face
Source: Principles of Pediatric Dermatology

The virus can also spread through skin contact with contaminated objects like towels, clothes, or toys. For example sharing clothes is a common cause. The virus is also spread between athletes that come in close contact such as gymnasts that touch common surfaces or wrestlers.

People with a weakened immune system such as those with HIV/AIDS may have a worse type of molluscum contagiosum infection.

Diagnosis

The condition is easily diagnosed from its appearance, but a skin biopsy may help confirm the diagnosis and rule out other possible skin infections.

A differential diagnosis is needed since the condition can look like:

  • Chickenpox
  • Warts
  • Skin cancer

Symptoms

This common skin infection is characterized by single or multiple, rounded, pink, dome-shaped, pearly papules that are about 2-5 mm in diameter. The papules have dimples (umbilicated) and contain a white, cheesy plug. They may be seen in lines, where scratching has occurred, or in groups (also called crops). In children, they are often found on their faces, necks, armpits, arms, and hands. They may also be found in other places of the body such as the genitals, buttocks, abdomen, and inner thighs, especially in sexually active adults, but not in the palms or soles. The average outbreak has 10 to 20 papules or skin bumps.

Molluscum Contagiosum Signs and Symptoms

  • Start as small pink skin growths
  • Smooth to the touch with a wax like feel
  • Dimpled in the center
  •  Do not cause pain
  • May itch
  • Turn red as the body fights the infection
  • Can appear on different body parts
  • Scratching can spread the condition

There is usually no associated inflammation or redness except if one has been scratching or digging the lesions. Skin lesions may disappear without treatment after a few months, but recurrence may occur. They usually leave no scars except when intense scratching causes skin damage. However, in patients who have weak immune systems, the disorder may persist and may be complicated by a superimposed bacterial infection.

Treatment and Cure for Molluscum

In most cases where infected individuals have normal immune systems, the molluscum contagiosum usually may go away on its own over a few months to years. This is often the approach taken in children. However, in persons with a compromised immune system, the condition may become rapidly worse.

Some people prefer to have their skin treated so as to avoid scratching and to improve their appearance. Individual papules may be surgically removed by scraping (curettage), de-coring (evisceration), freezing (cryosurgery), or using needle electrosurgery.

Pulsed dye laser for molluscum contagiosum has also been found to produce excellent results. It is well tolerated and does not produce scars or pigment changes. The treatment is quick and effective but it is more costly.

Topical medications may be helpful in removing lesions, but these can cause blistering and temporary skin discoloration. These medications include cantharidin, tretinoin 0.1% cream, imiquimod cream, 10% iodine solution, 10% potassium hydroxide, and Cidofovir. Products include Imiquimod (liquid topical applied to bumps for stubborn conditions) and Retinoids.

There are also natural treatment options available that use plant extracts to assist with symptom relief such as Naturasil. A recent study shows a 90% or greater reduction in visible molluscum lesions in children age 16 to 19 using a combination of essential oils with Melaleucaalternifolio (tea tree oil) - (Markum E, Baillie J (2012). "Combination of essential oil of Melaleucaalternifolia and iodine in the treatment of molluscum contagiosum in children". J. Drugs Derm. 11 (3): 161–165.).

For patients with weakened immune functions, skin eruptions may be widespread and disfiguring. Local treatments are ineffective, and antiviral medications as well as immune system strengthening therapy may be necessary.

The condition continues to be contagious until all skin bumps are healed. In most people, skin bumps will disappear in 2 to 4 months. The exception is anyone with a weakened immune system.

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References for Red Spots on Skin:

A.D.A.M. Medical Encyclopedia.Molluscum contagiosum.

Hanson, D and Diven, D. Mulluscum Dermatology Online Journal 9(2):

Bhatia, A. Molluscum Medscape.

American Academy of Dermatology

 




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